• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.19 no.1
• /
• pp.74-86
• /
• 2012

Purpose: The purpose of this study was to develop a comprehensive self-management program promoting self efficacy for Type 2 diabetic patients. Methods: The study was a methodological research design in which previous related research was reviewed to develop the comprehensive self-management program promoting self efficacy using self efficacy theory. Results: Comprehensive self-management programs promoting self efficacy included the whole range of eight self-management domains: diet, exercise, medication, self-testing of blood glucose, complication or foot, stress, time, and general health, and consisted of four sources of self efficacy: enactive mastery experience, vicarious experience, verbal persuasion, and physiological and affective states, as strategies to promote self efficacy. Developmental methods included, in addition to large and small group education, individual education or counseling, and telephone counseling. Conclusion: Further studies are needed in community health centers or hospitals to establish the effects on self-management compliance and glycemic control of the comprehensive self-management program promoting self efficacy.

• Clinical and Experimental Pediatrics
• /
• v.54 no.2
• /
• pp.45-50
• /
• 2011

Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic ${\beta}$ cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.19 no.2
• /
• pp.168-178
• /
• 2012

Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.

• Research in Community and Public Health Nursing
• /
• v.28 no.2
• /
• pp.216-225
• /
• 2017

Purpose: The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes. Methods: The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and hierarchical regression analysis. Results: The study results showed that self-care behavior (${\beta}=-.34$, p<.001), empowerment (${\beta}=-.34$, p<.001), and social support (${\beta}=-.20$, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%. Conclusion: Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.19 no.1
• /
• pp.74-82
• /
• 2012

Purpose: The aim of this study is to evaluate the effects of community based chronic disease management program for managing hypertension and diabetes mellitus. Method: The subjects of this study were 1,000 clients, who participated in a city community based chronic disease management program. The data were collected by a phone survey directly, and selected from DB of community based chronic disease management program, indirectly. The data were analyzed by the STATA program, using descriptive statistics, t-test, and Multiple regression analysis. Results: The mean score of knowledge of hypertension was 4.33 and diabetes mellitus was 2.52. The affecting factors of knowledge of hypertension were the clinic visiting point and blood sugar. However, the affecting factors of knowledge of diabetes mellitus was core lab point, diastolic blood pressure, and blood sugar. Conclusion: the results of this study showed that knowledge of hypertension increased with higher level of education, and younger ages, while knowledge of diabetes mellitus increased with higher level education, more core lab point, younger ages, and in males. Therefore, to control the chronic diseases more effectively in a community, it is important to develop a more systematic education and self- managing programs, using collaboration of health centers and local clinics.

• Journal of Korean Academy of Nursing
• /
• v.52 no.5
• /
• pp.535-549
• /
• 2022

Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.22 no.2
• /
• pp.206-215
• /
• 2015

Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.

• Journal of Korean Academy of Nursing
• /
• v.23 no.2
• /
• pp.170-186
• /
• 1993

This study evaluated the effect of diabetic group teaching programs in one university hospital in Seoul to predict when re-education would be needed. This study examined the patients’ knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 24 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ; p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t= -4.27 ; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43 : p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected( t=1.49 ; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086 ; p=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self-care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a diabetic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found be-ween self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowledge and self-care performance incense of three months after the teaching program but decrease of six months. Reeducation would be needed between three and sir months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.

• Health Policy and Management
• /
• v.20 no.3
• /
• pp.157-172
• /
• 2010

This study was conducted to evaluate the effects of health-behavioral change for the elderly group after community based education of chronic diseases management. We measured self recognition of health status, medication administration of hypertension and diabetes, regular check for blood pressure and blood sugar level, recognition of body indicators (weight, hight, blood pressure, blood sugar etc), knowledge level for chronic diseases management and smoking and alcohol habitation before and after education of chronic diseases management for participants. The subjects of this study consist of 432 people with community-dwelling Seoul citizen being active churches. Education programs designed essential parts of fundamental chronic diseases management, physical exercises for health promotion, diet and nutrition etc. All data collection completed for 5 months from Aug. 2008 to Dec. 2008 by trained surveyors via interview survey. The data obtained were analyzed using descriptive statistics, Wilcoxon Singed Rank test, McNemar test and Paired t-test. The results showed that self recognition of health status, knowledge level for chronic diseases management, recognition of body indicators were statistically significantly increased after the education of chronic diseases management. Also, blood pressure were statistically significantly decreased in elderly with hypertension and blood sugar were statistically significantly decreased in elderly of high-risk group. Based on these results, it was suggested that preventive education policy of chronic diseases management should be considered with priority coming true for successful aging society.

• Journal of Korean Academy of Nursing
• /
• v.37 no.2
• /
• pp.192-200
• /
• 2007

Purpose. The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes. Methods. A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college. Results. Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced 'conflict involving choosing a college and major'. The participant tried to be in charge of managing her diabetes and stepped forward to 'adaptation to college life as a new environment', and she learned more about the process of 'evolving awareness of caring' and developed herself further through the process of 'integration of the nurse identity into self-identity', and finally through the process of 'progression and preparation for getting a job' she achieved her goals, being positive about the future. Conclusions. The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.